Broken Promise, Lost Lives: Government's Bowel Cancer Screening Pledge 98% Undelivered
Despite a 2023 election pledge from Christopher Luxon and the Health Minister to lower the screening age from 60 to 45 to match Australia, just 2% of that commitment has been delivered. More than 900,000 New Zealanders remain without access to the screening that is standard care across the Tasman— a tool proven to detect cancer earlier and save lives.
Bowel Cancer NZ has presented the Government with a clinically backed, affordable proposal to protect one million more New Zealanders by lowering the screening age to 45 for all, and to 35 for Māori and Pasifika, who face higher risk at younger ages. A petition supporting its proposal has been signed by 13,000 New Zealanders and is before Parliament.
Peter Huskinson, Chief Executive of Bowel Cancer NZ says New Zealand has one of the highest rates of bowel cancer in the world. It remains the country's second deadliest cancer, despite the fact 90% of cases can be treated successfully if caught early.
'Sadly 1,200 lives are lost to bowel cancer in New Zealand every year, including 350 under the age of 50. And new research[i] is telling us that early onset bowel cancer is on the rise.'
Huskinson says screening is a simple, cost-effective solution that saves lives, and the Government must act now.
'Bowel cancer screening is a $30 test that prevents an $80,000 cancer. The human cost of delay is tragic – and the economic case for early detection couldn't be clearer. It is indefensible for more Kiwis to continue losing their lives to this preventable, treatable disease.'
To date, the Government has added just 20,000 people to the screening programme – scrapping a fully funded plan to screen 100,000 Māori and Pasifika aged 50–59 and instead extending eligibility to all 58–59-year-olds (120,000 people). This is despite clear evidence that Māori and Pasifika face significantly higher risk at younger ages.
'More than half of all Māori bowel cancers occur before the current screening age of 60 and for those diagnosed, it's often at a later stage when it's less treatable,' says Professor Sue Crengle, Medical Advisor for Bowel Cancer NZ.
"As a result, they have less opportunity to benefit from bowel cancer screening in its current form than other ethnic groups.'
As well as a higher risk of getting Bowel Cancer younger, data shows Māori are 46% more likely to die from bowel cancer than non-Māori, while Pasifika are 60% more likely.
'The system isn't acting early enough and is causing unnecessary suffering and deaths among Māori and Pacific communities - deaths that can be prevented with proper screening at the right age,' says Professor Crengle.
This Bowel Cancer Awareness Month, Bowel Cancer NZ is urging New Zealanders to know the symptoms, demand action, and add their voice to the call for a reduction in the screening age by writing a letter to their local MP. More information on this including MP details and a letter template can be found at https://bowelcancernz.org.nz/what-we-do/advocacy/
Know your symptoms: Bowel cancer symptoms can come and go. Don't wait — see your GP if you experience:
Bleeding from the bottom (rectal bleeding)
Change in bowel habits that come and go over several weeks
Persistent or sporadic abdominal pain
Loss of weight for no obvious reason and/or feel tired and weak (symptoms of anaemia)
Lump or swelling in the abdomen
Bowel cancer is preventable and treatable — but only if it's caught early. If something doesn't feel right, see your doctor.
More information on bowel cancer and the Bowel Cancer New Zealand charity can be found at
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In the week to come, there would be several more missteps, hastily scribbled costings and belated discoveries before 200 people would rise to their feet as Dad's ashes were carried from a church auditorium reverberating to the sonorous skirl of bagpipes. Funeral debt has become a national conversation, fuelled by hushed calculations in hospital hallways, heartfelt exclamations over post-funeral sausage rolls and heated declarations in parliamentary hearings. People are feeling the sharp financial pinch of the legal, health and societal requirements of dealing with the body of their loved ones and memorialising their memories. It is estimated a basic funeral package, using a funeral director, now costs about $7500 for cremation and $10,000 for burial. To pay these bills, one in three New Zealanders are suffering financial hardship that often lasts six months or longer, according to a survey conducted in 2019. Anecdotal evidence suggests that hardship is increasing. Last year, Parliament's health select committee decided to take a look at the power of the funeral industry and the cost of cremations and funerals. It heard from affordable funeral advocates Death Without Debt, as well as representatives of the Funeral Directors Association of New Zealand and the Ministry of Health, before reporting back to the House just over a month ago. Death without Debt (DWD) spokespeople told the politicians DIY funerals were far cheaper, but that only about 230 people took this option in 2023. A significant barrier to more DIY funerals was the industry's control of part of the death certification process, they said. DWD wanted more of the cremation paperwork put online and the funeral industry's role limited to disposal of the body. The Funeral Directors Association of New Zealand (FDANZ) took umbrage at what it described as DWD's "allegations of predatory behaviour". It did not think the funeral industry was broken, but added the government could improve things by finishing a review of the Burials & Cremations Act 1964, which began in 2010. The FDANZ urged the government to increase the maximum amount of the Work and Income funeral grant, currently $2445, and suggested legislation requiring funeral prices be transparent. It also argued the asset-testing threshold for funeral plans should be increased from $10,000 to $15,000 and said the legislative review should consider burial and cremation alternatives such as water cremation and human composting. The Ministry of Health (MoH) agreed burial and cremation processes, as dictated by law, were "outdated and disproportionate". It said it was in discussion with the Ministry of Business, Innovation and Employment and the Department of Internal Affairs about modernising funeral sector regulations. It estimated the cheapest option, a DIY funeral involving cremation, could be done for $1550. It appears most of the changes suggested to the health committee would do little to reduce the actual price of funerals, except for ideas that would help families more easily do it for themselves. It is certainly not easy at the moment. For Dad's funeral, we had to work hard and smart; we made mistakes but got there in the end. Implementation of changes suggested in the report, however, are mostly beyond the line of sight. In the meantime, in the hope it is useful, here is what our family found out and what we did. My Dad was a quiet, caring man — a retired school teacher and church minister — who loved rugby, a good joke and God. He was not perfect but was sincere and never, even in his final days, showed any signs of self-pity. Diagnosed in February with stage four melanoma that had spread to lung and brain, and declared beyond treatment two months later, he was reconciled to a shorter-than-expected life but was a little concerned about the process of a tumorous death. We, his family, were determined it would be as comfortable and pain-free as possible. That was an easy decision during the week we spent together while he could still walk, talk, eat and joke. Those days, especially after he ended up in hospital and palliative care doctors began appearing at the foot of his bed, were also filled with questions, lists and phone calls as we tried to navigate the alien world of death and dying. Doing it all ourselves was not a conscious decision; not at first. Faced with the option of filling out the 30-page Residential Care Subsidy (RCS) application ourselves or giving it to a lawyer to handle — "that's what a lot of people do" — an unspoken family belief in our capacity and a Scots-heritage aversion to unnecessary expense naturally led us down the DIY path. A couple of quick tips about the RCS application form that determines whether the State pays most of your loved one's asset-tested stay in rest home and hospital-level care: you can fill out the form as a "helper" without having Enduring Power of Attorney or having to apply to be an "agent"; while the form might be woefully worded, the Work & Income senior services call-centre staff are consistently fabulous; and even if the application is successful, your spouse or parent's superannuation plus the State's contribution might not cover the full, per-day cost of care. During that week, as well as precious moments and conversations with Dad and each other, we also settled on cremation rather than burial, selected a coffin and started to explore the bureaucracy of death. At my parents' nearest council-owned cemetery and crematorium, casket burials cost up to three times as much as the combined cost of cremation and ashes burial in a memorial plot. When a loved one dies, doing all the paperwork and many of the practical tasks is demanding, but a DIY funeral can save thousands of dollars. In the case of Bruce Munro's father, the cost was reduced from about $7500 to $4249 — more than 40% less than the average funeral involving cremation. In Dunedin, the differential is just as large — casket plot, internment fee and plot maintenance costs $5696.90, whereas cremation and internment in an ashes plot costs $1907.50. Dad's casket came from the local Coffin Club. During the past 15 years, more than half a dozen Coffin Clubs have popped up around the country — providing cheaper coffins and, in some cases, helping people build their own. There is only one in the South Island, the Kiwi Coffin Club Christchurch, started by Donna Sutherland, 12 years ago. Mrs Sutherland says demand has taken off during the past five years, driven by growing concern about the cost of funerals. In partnership with a local Men's Shed, the Christchurch club supplies about 100 adult-sized coffins each year — including the occasional one south of the Waitaki River — plus more than that number of "angel boxes" for babies. One of their plain, adult-sized MDF caskets costs $475; another $200 gives it a coat of paint. By comparison, the starting price of caskets available from Otago and Southland funeral directors ranges from $1150 to $1995. Dad's coffin was made of MDF, with wooden handles, lined, painted glossy white and met local crematorium standards. We know he was happy with it because he asked to see photos, joking he would not be able to see it when he needed it. By the end of those 10 days together as a family, Dad had been transferred to the hospital-level care facility. My brother and I then flew to our respective homes, having said our goodbyes to Dad; leaving Mum, our sister and her family to do shifts at his bedside, bearing a fortnight's helpless witness to the steady depletion of his life force. It was about then we got valuable guidance from two sources, started filling out the paperwork that would soon be needed and seriously wondered whether we had made the wrong decision. One information resource was the local crematorium, the other a death doula. Photos: supplied Death doulas, also known as death midwives, can educate, support and advocate for people preparing for death and those closest to them. The End of Life Doula Alliance Aotearoa lists dozens of professional and informal doulas, including a handful in Otago and Southland. The phone call yielding the crematorium's free guide to organising a private cremation and the death doula's $100 consultancy were both money well spent; each providing largely overlapping information we then cross-referenced to work out who did what, what forms needed to be filled in, when and sent to who. This is not a watertight list, but it might be helpful: When Dad died, the care facility would wash and dress his body; the GP would complete a Medical Certificate of Cause of Death, Cremation Forms B and AB and Death Documents ($200 approx); we would arrange to remove Dad's body and ask the death doula to deliver the manaaki mats ($50); we would fill out the Application for Cremation and send it, along with all the death documents from the GP, to the Medical Referee; the Medical Referee would then fill out and send us Form F ($48); we would then book the cremation and, if we wanted, book to view the cremation; on the right day and time we would turn up at the crematorium with Dad's body in a compliant coffin, hand over the paperwork and pay for the cremation ($1125); within three days of the cremation we would register the death with Births, Deaths and Marriages ($33 to get the Death Certificate posted); and at about the same time, the ashes would be ready to collect from the crematorium in readiness for the memorial service. That's the theory. In practice, we reached a point one night a few days before Dad died — talking online in three cities across two hemispheres — at which we thought maybe we did need a funeral director. The forms were still confusing, negotiations with the care facility were getting ridiculous, and the logistics of caring for Dad's body without embalming until the cremation could occur seemed fraught with difficulty. We already had a quote from a funeral director for just the basics — arranging transfer of the body, care of the body for two nights, handling all the paperwork, delivering the body to the crematorium — but had decided against it after realising we could save $2480 by doing those things ourselves. For a moment that evening our resolve wobbled, thinking Mum might prefer to have a funeral director take it all off her plate. But she was the one who said, "No, we're well on our way, we can do this." I was five hours' drive from my home and an inter-island flight away from my parents' city when I woke to the message that Dad had died, peacefully, during the night. It was the afternoon of the next day before I could get there. By then, the care facility staff had gathered for a touching farewell as Dad's body exited the building; the coffin was placed in the coolest room of my parents house, the garage; and the GP had visited to view the body and fill out the forms that should have been completed at the outset. Dad had died at the start of a long weekend, which was challenging. The crematorium was phoned, messages left, forms emailed through; but it would be Tuesday before we could speak to anyone to confirm the cremation date. Then, we would still need to get the cremation done, wait three days for the ashes and then pick them up in time for the memorial service that an ever-growing number of people said they would be attending. The death of ODT journalist Bruce Munro's father, Murray Munro, 87, six weeks ago, led to the family organising a DIY funeral to celebrate his life. Photos: supplied All we could do was get on with caring for Dad's body, prepare for the service and pray it would all come together. Caring for his body mostly meant, every eight hours, changing the dry-ice gel manaaki mats covering his body and replacing the frozen water bottle beneath the crook of his neck. It was confronting, good for the grieving process — my main impression was just how thoroughly devoid of life his body was, a costume he had cast off. There were plenty of other things to do, including planning the service in which we were all going to take a full part. Mum and Dad's church community lifted the load significantly, offering to take care of flowers, most of the music, catering and printing the service booklet. Hurrying back with Mum from a shopping mall visit to get a memorial book for guests to sign, I was pulled over by a gaggle of police with speed cameras. Why were you doing 71kmh in a 60kmh zone? I'm just heading home to put my father's coffin in the back of the vehicle that will hopefully take it to the crematorium tomorrow, I replied. How about we make that 70kmh, dropping the fine from $80 to $30? That would be great, thank you. In the end, we had the ashes with a day to spare. A DIY funeral can be confronting, but it aids the grieving process and gives family and friends a chance to participate deeply in honouring the person's memory. Photo: supplied The parliamentary health select committee concluded "the current process and regulations impose high costs on the public and create a barrier for people who want to organise their own funerals, particularly when their loved ones are about to be cremated". Our family agrees. We got there, but it was a mission and not a cheap one. At the same time, although harder to navigate than it needs to be, DIY is eminently do-able and will save thousands of dollars. Taking into account the unavoidable costs plus extras such as death doula, manaaki mats, bagpiper, memorial garden ashes plot and koha to the church and livestream technician, we spent a total of $4249 — more than 40% less than the average cremation and almost 60% less than a typical burial. The select committee's report encourages the Ministry of Health (MoH) to prioritise updating cremation regulations and to carry out planned work to facilitate DIY funerals. An easy win, it says, would be for the Department of Internal Affairs (DIA) to make it easier to find DIY funeral information on the Te Hokinga ā Wairua End of Life Service website. In response to questions from The Mix, an MoH spokeswoman said a review, to make sure authorising cremation when the deceased had been in a care facility was as streamlined and cheap as possible, should be completed this year. But any legislative changes would need agreement from the government, she said. A DIA spokesman said work was under way to improve the website. Dad's memorial service was a month after we first gathered as a family and seven days after he died. It was a sad, wonderful and hope-filled occasion. As the piper led us out to the rousing, haunting tune of Amazing Grace, I was pleased we had done so much of it ourselves; from caring for Dad's body to battling with the paperwork and organising the service. It had allowed us, and others who loved Dad and cared for us, to more fully celebrate his life, mourn our loss and honour his memory. DIY funeral The plan was ... • When Dad died the care facility would wash and dress his body. • The GP would complete a medical certificate of cause of death, cremation forms B and AB and death documents ($200 approx). • We would arrange to remove Dad's body and ask the death doula to deliver the manaaki mats ($50). • We would fill out the application for cremation and send it, along with all the death documents from the GP, to the medical referee. • The medical referee would then fill out and send us form F ($48). • We would then book the cremation and, if we wanted, book to view the cremation. • On the right day and time we would turn up at the crematorium with Dad's body in a compliant coffin, hand over the paperwork and pay for the cremation ($1125). • Within three days of the cremation we would register the death with Births, Deaths and Marriages ($33 to get the death certificate posted). • At about the same time, the ashes would be ready to collect from the crematorium in readiness for the memorial service.
